Optical obturator

ABSTRACT

An optical obturator apparatus includes an obturator sleeve defining a longitudinal axis and having a longitudinal bore for receiving surgical instrumentation and a transparent window mounted to the obturator sleeve and being dimensioned and configured to pass through tissue. The transparent window is mounted for movement between a first position in general alignment with the longitudinal axis of the obturator sleeve and a second position radially displaced from the longitudinal axis to thereby expose the longitudinal bore of the obturator sleeve to permit passage of the surgical instrumentation. The transparent window may include a cutting blade, or alternatively two cutting blades, adapted to penetrate tissue.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. patent applicationSer. No. 15,689,464, filed Aug. 29, 2017, which is a continuation ofU.S. patent application Ser. No. 12/276,632, filed Nov. 24, 2008, whichis a divisional application which claims the benefit of and priority toU.S. patent application Ser. No. 11/095,413 filed Mar. 31, 2005, nowU.S. Pat. No. 7,470,230, the entire contents of each of which areincorporated herein by reference.

BACKGROUND Technical Field

The present disclosure relates to an apparatus for penetrating bodytissue during minimally invasive surgical procedures, such as endoscopicor laparoscopic procedures. More particularly, the present disclosurerelates to an access assembly having a transparent window for providingvisual observation during penetration of the peritoneum or other bodytissue.

Background of Related Art

Minimally invasive surgical procedures including endoscopic andlaparoscopic procedures permit surgery to be performed on organs, tissueand vessels far removed from an opening within the tissue. Laparoscopicand endoscopic procedures are performed in the interior of the abdomenthrough a small incision such as, for example, a narrow endoscopic tubeor cannula inserted through a small entrance incision in the skin.Typically, after the abdominal cavity is insufflated, a trocar is usedto puncture the cavity wall, i.e., the peritoneal lining, to create apathway to the underlying surgical site. Generally, the trocar includesa stylet or obturator having a sharp tip for penetrating the bodycavity, which is positioned coaxially within an outer cannula. Theobturator is removed, leaving the outer cannula in place for receptionof instrumentation utilized to perform the surgical procedure. Anexample of a known trocar is described in commonly assigned U.S. Pat.No. 6,319,266 to Stellon, which issued Nov. 21, 2001, the contents ofwhich are incorporated herein in its entirety by reference. However,with known trocars, advancement of the obturator through tissue istypically performed blind, i.e., without visualization of the tissuebeing entered. Obturators allowing visualization include U.S. Pat. Nos.5,334,150, 5,431,151 and 5,441,041.

Accordingly, the present disclosure provides an optical access assemblywhich permits direct visualization of body tissue during penetration ofthe body cavity. Moreover, the optical access assembly of the presentdisclosure provides an improved structure for direct visualization ofthe body tissue being penetrated and serves as a conduit for subsequentintroduction of surgical instrumentation required for performance of thesurgical procedure.

SUMMARY

In one preferred embodiment, an optical obturator apparatus includes anobturator sleeve defining a longitudinal axis and having a longitudinalbore for receiving surgical instrumentation and a transparent windowmounted to the obturator sleeve and being dimensioned and configured topass through tissue. The transparent window is mounted for movementbetween a first position in general alignment with the longitudinal axisof the obturator sleeve and a second position radially displaced fromthe longitudinal axis to thereby expose the longitudinal bore of theobturator sleeve to permit passage of the surgical instrumentation. Thetransparent window may include a cutting blade, or alternatively twocutting blades, adapted to penetrate tissue.

A control member is connected to the transparent window and at leastpartially extends along the obturator sleeve. The control member isactuable to move the transparent window between the first position andthe second position. The control member is adapted to rotate about anaxis of rotation to cause movement of the transparent window between thefirst position and the second position. In this regard, the transparentwindow is adapted for pivotal movement about the axis of rotation tomove between the first position and the second position thereof. Thecontrol member may be adapted to move in a longitudinal direction from anormal position to an extended position to displace the transparentwindow relative to the obturator sleeve.

An anti-rotation member may be associated with the transparent window toprevent pivotal movement of the transparent window when the transparentwindow is in the normal position thereof. The anti-rotational memberincludes a key extending from one of the transparent window and theobturator sleeve, the key receivable within a keyed port defined in theother of the transparent window and the obturator sleeve. The key isremoved from the keyed port upon movement of the control member to theextended position.

A manually manipulative member may be operatively connected to thecontrol member. The manually manipulative member is movable to move thecontrol member.

In another preferred embodiment, a surgical optical viewing systemincludes an optical obturator having an obturator sleeve defining alongitudinal axis and a longitudinal bore for reception of surgicalinstrumentation,. The optical obturator includes a transparent windowfor permitting passage of light into the obturator sleeve. Thetransparent window has at least two separable window sections. The atleast two separable window sections are adapted for radial displacingmovement to expose the longitudinal bore and to permit passage of thesurgical instrumentation used for performing a surgical procedure. Thetransparent window may define a tapered configuration and at least onecutting blade adapted to penetrate tissue.

The optical viewing system may further include a surgical instrumentpositionable within the longitudinal bore of the obturator sleeve. Theat least two separable sections of the transparent window are adaptedfor radially displacing movement in response to longitudinal movement ofthe surgical instrument relative to the obturator sleeve. In thisregard, the surgical instrument is engageable with interior surfaces ofthe at least two separable sections of the transparent window uponrelative longitudinal movement of the surgical instrument and theobturator sleeve to radially displace the at least two separablesections.

BRIEF DESCRIPTION OF THE DRAWINGS

Preferred embodiments of the present disclosure are describedhereinbelow with references to the drawings, wherein:

FIG. 1 is a side view in partial cross-section of one embodiment of anoptical access assembly constructed in accordance with the presentdisclosure;

FIG. 2 is an enlarged side cross-sectional view of the housing of theaccess assembly in accordance with the embodiment of FIG. 1 illustratingthe sealing system for forming a fluid tight seal about a surgicalinstrument;

FIG. 3 is a cross-sectional view of the obturator sleeve of the opticalaccess assembly in accordance with the embodiment of FIGS. 1-2 and takenalong section lines 3-3 of FIG. 1;

FIG. 4 is a view illustrating a bevel gear arrangement associated withthe sleeve of the optical access assembly in accordance with theembodiment of FIGS. 1-3;

FIG. 5 is a an axial view illustrating the transparent window of theoptical access assembly in accordance with the embodiment of FIGS. 1-4;

FIG. 6 is view of an alternative embodiment of the transparent window ofthe optical access assembly;

FIG. 7 is a side view in partial cross-section of the optical accessassembly in accordance with the embodiment of FIGS. 1-5, illustratingmovement of the transparent window from a first positioned aligned withthe sleeve and a second position displaced from the sleeve;

FIG. 8 is an axial view further illustrating movement of the transparentwindow from the first position to the second position in accordance withthe embodiment of FIGS. 1-5 and 7;

FIG. 9 is a view similar to the view of FIG. 7 illustrating advancementof a surgical instrument through the sleeve and beyond the transparentwindow for performing a surgical procedure;

FIG. 10 is a side view in partial cross-section of an alternativeembodiment of an optical access assembly of the present disclosure;

FIG. 11 is an axial view illustrating the transparent window inaccordance with the embodiment of FIG. 10;

FIG. 12 is a view similar to the view of FIG. 10 illustrating radialmovement of the window segments of the transparent window to open thesleeve of the optical access assembly in accordance with the embodimentof FIGS. 10-11;

FIG. 13 is axial view further illustrating the radial movement of thewindow segment of the transparent window; and

FIG. 14 is a side view in partial cross-section of another embodiment ofan optical access assembly of the present disclosure.

DETAILED DESCRIPTION

Referring now in detail to the drawing figures, in which, like referencenumerals identify similar or identical elements, there is illustrated inFIG. 1, an optical access assembly constructed in accordance with apreferred embodiment of the present disclosure, and designated generallyby reference numeral 100. Optical access assembly 100 contemplates thedirect visualization of body tissue during penetration of the peritonealcavity or other tissue portions. In addition, optical access assembly100 facilitates the introduction of various types of surgicalinstruments such as, for example, an endoscopic clip applier, grasper,dissector, retractor, stapler, photographic device, tube, and the like.Optical access assembly 100 is dimensioned to pass through body tissueand may incorporate structure to cut, puncture, or pierce the bodytissue.

Generally, optical access assembly 100 includes housing 102, sleeve 104secured to housing 102 and extending distally therefrom and window 106operatively connected to the distal end of sleeve 104. Housing 102 mayincorporate several components connected to each other by conventionalmeans or may be a single component. As best depicted in FIGS. 1-2,housing 102 is advantageously dimensioned to be grasped by the surgeon.Housing 102 includes an internal sealing system to receive a surgicalinstrument in substantial sealed relation therewith while also providinga substantial seal between the body cavity and the outside atmosphereboth during, and subsequent to, insertion of the surgical instrumentthrough sleeve 104. One exemplative sealing system suitable for use inoptical obturator assembly 100 is shown in FIG. 2. This sealing systemis disclosed in commonly assigned U.S. Published Application No.2004/0066008 to Smith, the entire contents of which are herebyincorporated by reference. The sealing system includes instrument seal108 and zero-closure seal 110. Instrument seal 108 is formed of aresilient material and has an aperture 112 for sealed reception of asurgical instrument. A fabric layer 114 is juxtaposed relative to theresilient material and may be disposed on either, or both of, theproximally facing surface or distally facing surface of instrument seal108. The preferred fabric includes a SPANDEX™ material containing 20%LYCRA from Milliken. Zero closure valve 110 is preferably a duck billvalve which opens to permit passage of the surgical instrument. Duckbill valve 110 desirably closes in the absence of the surgicalinstrument and/or in response to the pressure of the insufflation gases.Housing 102 further includes insufflation connector or port 116 (FIG.1). Insufflation connector 116 is adapted for connection to a supply ofinsufflation gases for introduction within the peritoneal cavity as isconventional in the art. Further details of the sealing system may beascertained by reference to the Smith '008 publication.

With reference to FIGS. 1 and 3, sleeve 104 defines longitudinal axis“x” and has longitudinal bore 118 extending the length of the sleeve104. Longitudinal bore 118 permits the introduction of a surgicalinstrument utilized in the surgical procedure. Sleeve 104 preferably hasa diameter of between about 4 millimeters to about 14 millimeters.Sleeve 104 may be constructed of a medical grade metal includingstainless steel or titanium or a suitable biocompatible polymericmaterial. Sleeve 104 further includes control member 120 (shownpartially in phantom in FIG. 1) which extends through passage 122defined in the sleeve 104. Control member 120 serves to mounttransparent window 106 and also moves the transparent window 106 betweena first position aligned with longitudinal axis and a second positiondisplaced from the longitudinal axis “x”. In this regard, control member120 is adapted to rotate within passage 122 (i.e., about an axis ofrotation “c” which is in general parallel to axis “x” of obturatorsleeve 104) and is also adapted for limited longitudinal movement withinpassage 122.

A manual manipulative handle 124 extends radially outwardly from theproximal end of control member 120. Handle 124 is advantageouslydimensioned for gripping engagement by the user and is actuable toeffectuate rotational and/or longitudinal movement of control member 120and thus corresponding movement of window 106. More specifically, handle124 is mechanically connected to control member 120 in a manner wherebyrotational movement of the handle 124 about handle axis “h” causescorresponding rotational movement of the control member 120 about axis“c”. Any means for transferring this rotational motion are envisionedincluding, e.g., the bevel gear arrangement depicted in FIG. 4. In thisregard, handle 124 may be integrally formed with first gear 126 andcontrol member 120 may be integrally formed with second gear 128. Firstand second gears 126, 128 cooperate whereby rotational movement ofhandle 124 and first gear 126 about handle axis “h” causes correspondingrotational movement of control member 120 about control axis “c”. Thebevel gear arrangement may be appropriately miniaturized to residewithin passage 122 of the wall of obturator sleeve 104 or may bedisposed within housing 102. In addition, handle 124 is adapted to movein the longitudinal direction within slot 130 of obturator sleeve 104 inresponse to proximal and distal applications of force by the surgeon.

Sleeve 104 further defines keyed notch 132 in its distal end. Keyednotch 132 serves to prevent rotation of window 106 during introductionwithin the body tissue.

Referring now to FIGS. 1 and 5, window 106 will be discussed in detail.Window 106 permits visualization during penetration of the body tissue.Window 106 may comprise a transparent or translucent polymeric materialand be fabricated via known injection molding techniques. Alternatively,window 106 may comprise an optical glass. The term “transparent” is tobe interpreted as having the ability to permit the passage of light withor without clear imaging capabilities. Moreover, the transparentmaterial includes any material which is not opaque. It is also to beappreciated that only a portion of transparent window 106 needs to betransparent. Thus, a portion of, or the entire window 106, may betransparent or translucent. Window 106 may have a unitary constructionor be comprised of multiple parts.

Window 106 is generally tapered in configuration, e.g., bulbous,hemispherical, or pyramidal conically-shaped, to facilitate passagethrough body tissue. Window 106 may include an image directing member(not shown) for directing optical images into longitudinal bore 118 ofsleeve 104 or back to an image apparatus. The image directing member maybe a lens, an optical prism, an optical mirror, or like image directingmedium.

As best depicted in FIG. 3, transparent window 106 preferably has atleast one cutting blade 134. Cutting blade 134 is preferably centeredwith respect to the outer surface 136 of window 106, as shown. Thusduring visualization, cutting blade 134 is seen as a thin line throughthe center, i.e. bisecting the viewing field so as not to substantiallyobstruct viewing of the body tissue. Cutting blade 134 may be anindependent member secured to outer surface 136 by conventional meansincluding welding, cements, etc. Alternatively, cutting blade 134 may beintegrally formed with window 106 during, e.g., in a molding process. Inthis embodiment, cutting blade 134 is made of a polymeric material andis integrally formed with window 106. form. In one embodiment, cuttingblade 134 includes a single cutting blade. Alternatively, twointersecting cutting blades 134 arranged in an X pattern, may beprovided as shown in FIG. 6. Other arrangements of cutting blade 134 areenvisioned, such as, for example, arrangements of three, four, etc., ofthe cutting blades 134. One or more cutting blades 134 may be disposedalong lateral sides of window 106.

Window 106 further includes anti-rotation key 136. Anti rotation key 136resides within keyed notch 134 of sleeve 104 to prevent rotation of thesleeve 104 during introduction of window 106.

In operation, the peritoneal cavity is insufflated to raise the cavitywall to provide greater access to tissue and organs therewithin. Anendoscope 200 is inserted into optical access assembly 100, i.e.,through housing 102 and into longitudinal bore 118, as shown in FIG. 2.One suitable endoscope for use with optical access assembly 100 isdisclosed in commonly assigned U.S. Pat. No. 5,718,664 to Peck et al.,the contents of which are incorporated herein by reference. Instrumentseal 108 of housing 102 forms a fluid tight seal about the endoscope200. As appreciated, endoscope 200 is advanced within sleeve 104 untilthe distal end of the endoscope 200 is adjacent window 106. In thisposition, the distal lens element of the endoscope 200 is capable ofviewing the tissue being entered. Endoscope 200 may be secured relativeto optical obturator assembly 100 with a locking system (not shown), atthe proximal end of the optical access assembly 100, at some locationalong sleeve 104, or at the distal end of sleeve 104. For example, thelocking mechanism may comprise a cam mechanism, or a ledge at the distalend of sleeve 104.

The procedure is continued by positioning window 106 against the bodytissue “t” and advancing the assembly 100 to permit cutting blade 134 topenetrate the tissue. A skin incision may be made before pressing window106 against the tissue, if desired. During penetration of the bodytissue, the surgeon observes the underlying tissue through the endoscope200 to ensure there is no undesired contact with organs, tissue, etc.lying beneath the peritoneal lining. In instances where a video systemis utilized, the surgeon simply observes the penetration of body tissue“t” via any known video monitor. Once the surgeon penetrates the bodytissue “t” as observed through the endoscope 200, the surgeondiscontinues the application of force. For example, in penetration ofthe abdominal wall, the surgeon can observe the peritoneum andpenetration thereof.

After penetration into the underlying body cavity, handle 124 is movedin the distal direction within slot 130 of obturator sleeve 104 to movecontrol member 120 from its normal operative position depicted in FIG. 1to the extended position depicted in FIG. 7. During this distalmovement, anti-rotation key 136 of transparent window 106 clears keyednotch 134 within obturator sleeve 104. Once key 136 is cleared from itscontainment within keyed notch 134, handle 124 is rotated about handleaxis “h” (FIG. 4) which causes corresponding rotation of control member126. The rotational movement of control member 120 causes transparentwindow 106 to rotate around axis of rotation “c” to the radiallydisplaced position depicted in FIGS. 7 and 8. In this position,longitudinal bore 118 of sleeve 104 is exposed. Endoscope 200 may thenremoved from longitudinal bore 120 for insertion of other desiredsurgical instruments 300 to carry out the desired procedure as shown inFIG. 9. Although FIG. 7 shows an endoscope 200 with an eye piece, theendoscope 200 may be additionally or alternatively connected to animaging system, which may include a computer.

With reference to FIGS. 10-13, an alternative embodiment of an opticalobturator assembly of the present disclosure is illustrated. In FIG. 10,optical access assembly 400 is shown with a cannula assembly 500 atleast partially positioned therein and a conventional endoscope 200introduced within the cannula assembly 500. Optical access assembly 400generally includes handle 402 and sleeve 404 extending distally from thehandle 402. Handle 402 and sleeve 404 may be separate components orintegrally formed during manufacture. Adjacent the distal end of sleeve404 is window 406. Window 406 is transparent or translucent as discussedhereinabove and preferably is integrally formed with sleeve 404. Window406 includes a plurality of individual separable window sections 408(FIG. 12) which are capable of radial displacement to permit passage ofa surgical instrument. Desirably, window 406 and/or the entire sleeve404 is made from a relatively flexible material. In the preferredembodiment, four window segments 408 are provided with each of thesegments 408 separated from adjacent segment 408 by respective slits410. Window 406 further includes a pair of intersecting cutting blades412. Cutting blades 412 function in penetrating or piercing body tissue.

Cannula assembly 500 may be similar to any conventional cannula assemblyadapted for use in laparoscopic surgery. Cannula assembly 500 includescannula housing 502 and cannula 504 extending from the cannula housing502. An internal seal assembly may be mounted within cannula housing 502for sealed reception of a surgical instrument such as an endoscope. Onesuitable seal system is disclosed hereinabove in connection with thediscussion of FIG. 2 any suitable seal system for cannula assemblies maybe used.

In operation, cannula assembly 500 is positioned within optical accessassembly 400 followed by insertion of an endoscope 200 within thecannula assembly 500. Endoscope 200 is positioned within access assembly400 such that distal lens element 202 of endoscope 200 does not extendbeyond the distal end of access assembly 400 as shown in FIG. 10.Thereafter, the surgeon penetrates the body tissue “t” while observingthe penetration through the eyepiece of the endoscope 200 (or whileobserving the same on an imaging and/or computer screen), as describedin detail hereinabove. Endoscope 200 may then be removed if desired.Subsequent to penetration of the body cavity, the surgeon engages handle402 to move sleeve 404 in the proximal direction as depicted in FIG. 11.Proximal movement of obturator sleeve 404 causes the distal end ofcannula 504 to engage internal surfaces 414 of window sections 408.Accordingly, window sections 408 are biased outwardly to the arrangementshown in FIG. 13. In this position, window sections 408 are radiallydisplaced from longitudinal axis “X” to thereby expose cannula 504, thuspermitting passage of surgical instrumentation through the cannula 504and into the underlying body cavity.

With reference to FIG. 14, another embodiment of an optical accessassembly of the present disclosure is illustrated and designatedgenerally as optical access assembly 600. Access assembly 600 generallyincludes handle 602 and sleeve 604 defining a longitudinal axis “X”. Awindow 606 having cutting blade 608 is formed at the distal end ofsleeve 604. Desirably, the window 606 is transparent or translucent, asdiscussed above in connection with FIGS. 1, 5 and 10. Endoscope 200 ispositioned within sleeve 604 to provide for observation of the bodytissue being penetrated. Endoscope 200 includes an endoscopic shaft 202which is frictionally engaged by the internal surfaces of sleeve 604,i.e., sleeve 604 may be dimensioned to form a friction fit with theendoscopic shaft 202 to thereby retain endoscope in a desired positionrelative to sleeve 604 with the distal lens component adjacent window606. Alternatively, a locking system, as discussed above in connectionwith FIG. 2, may be used. In use of this embodiment, endoscope 200 inpositioned within access assembly 600 and the desired frictionalrelationship is established between endoscopic shaft 202 and accesssleeve 604. The system is advanced through the tissue with visualizationprovided by endoscope 200 through window 206.

In further embodiments, the optical access assembly is as discussedabove in connection with FIGS. 1-5 and 7-9, except that the window haswindow sections that are arranged as jaws pivotally mounted on thedistal end of the sleeve. An elongated member extending proximally,along the sleeve, cooperates with a handle or other structure foractuating the jaws. During actuation, the jaws move from a closedposition to an open position. The jaws may or may not include blades.The jaws, when in a closed position, may have any shape, such aspyramidal, conical, dolphin-nosed, hemispherical, etc. The pivotablejaws are translucent or transparent, as discussed above, and the user ofthe optical access assembly views tissue before, during and afteradvancement of the optical access assembly. The jaws may be actuatedwhile the assembly is advanced through tissue, or after the tissue hasbeen penetrated and the body cavity accessed.

In further embodiments, the optical access assembly is as discussedabove in connection with FIGS. 1-5 and 7-9, except that the windowcomprises a closed, pyramidal, conical, dolphin-nosed, and/or preferablyhemispherical shape. An elongated member extending proximally, along thesleeve, cooperates with a handle or other structure for rotating thewindow away from the distal end of the sleeve. The window rotates from aposition closing the distal end of the sleeve, to a position that leavesthe distal end of the sleeve open. The window may or may not include oneor more blades. The user of the optical access assembly views tissuebefore, during and after advancement of the optical access assembly.

In each of the embodiments discussed above, the window may or may notinclude cutting blades. The window may have any shape, such aspyramidal, conical, dolphin-nosed, hemispherical, etc. In each of theembodiments discussed above, the endoscope may include an eyepiece,and/or a connection to imaging equipment which may include a computer.In each of the embodiments discussed above, the movement of the window,jaws, or window sections is driven by an electric motor, hydraulicdriver or manual drive and may be controlled utilizing electrical ormechanical methods.

It will be understood that various modifications can be made to theembodiments of the present invention herein disclosed without departingfrom the spirit and scope thereof. For example, various diameters forthe obturator assembly, cannula assembly, as well as various diametersfor the surgical instruments are contemplated. Also, variousmodifications may be made in the configuration of the parts. Therefore,the above description should not be construed as limiting the inventionbut merely as exemplifications of preferred embodiments thereof. Thoseskilled in the art will envision other modifications within the scopeand spirit of the present invention as defined by the claims appendedhereto.

1. (canceled)
 2. An optical access apparatus, comprising: an obturatorsleeve defining a passageway, the passageway defining a longitudinalaxis and configured to receive surgical instrumentation at leastpartially therethrough; and a tip disposed adjacent a distal end of theobturator sleeve, the tip being rotatable about an axis of rotationbetween a first position where a distal end of the tip is in generalalignment with the longitudinal axis and a second position where thedistal end of the tip is offset from the longitudinal axis, wherein thetip is selectively prevented from rotating about the axis of rotationrelative to the obturator sleeve.
 3. The optical access apparatusaccording to claim 2, wherein when the tip is in the first position, thetip restricts surgical instrumentation from being advanced through thepassageway to a position that is distally beyond the tip.
 4. The opticalaccess apparatus according to claim 3, wherein when the tip is in thesecond position, surgical instrumentation is permitted to advancethrough the passageway to a position that is distally beyond the tip. 5.The optical access apparatus according to claim 4, further including acontrol member disposed in mechanical cooperation with the tip andextending along at least a portion of the obturator sleeve, the controlmember being actuable to move the tip between the first position and thesecond position.
 6. The optical access apparatus according to claim 2,wherein the tip includes a cutting blade adapted to penetrate tissue. 7.The optical access apparatus according to claim 6, wherein the cuttingblade is included on the distal end of the tip.
 8. The optical accessapparatus according to claim 2, wherein the tip allows light to passtherethrough.
 9. The optical access apparatus according to claim 2,further including a notch disposed on one of the obturator sleeve or thetip, and a key disposed on the other of the obturator sleeve or the tip,the notch and the key cooperate to selectively prevent the tip fromrotating about the axis of rotation relative to the obturator sleeve.10. The optical access apparatus according to claim 9, wherein distalmovement of the tip relative to the obturator sleeve causes the key todisengage the notch thereby permitting rotation of the tip relative tothe obturator sleeve.
 11. The optical access apparatus according toclaim 10, further including a control member disposed in mechanicalcooperation with the tip and at extending along at least a portion ofthe obturator sleeve, the control member actuable to move the tipbetween the first position and the second position, and the controlmember actuable to move the tip distally relative to the obturatorsleeve.
 12. The optical access apparatus according to claim 11, furtherincluding a handle disposed in mechanical cooperation with the controlmember, distal movement of the handle relative to the obturator sleeveactuates the control member and moves the tip distally relative to theobturator sleeve, and rotation of the handle about a handle axisactuates the control member and moves the tip between the first positionand the second position.
 13. The optical access apparatus according toclaim 12, further including a bevel gear disposed between the handle andthe control member.
 14. A surgical access apparatus, comprising: anobturator sleeve defining a passageway, the passageway defining alongitudinal axis and configured to receive surgical instrumentation atleast partially therethrough; a tip disposed adjacent a distal end ofthe obturator sleeve, the tip being rotatable about an axis of rotationbetween a first position where a distal end of the tip is in generalalignment with the longitudinal axis and a second position where thedistal end of the tip is offset from the longitudinal axis, wherein thetip is selectively prevented from rotating about the axis of rotationrelative to the obturator sleeve; and a gear disposed in mechanicalcooperation with the tip, wherein rotation of the gear rotates the tipbetween the first position and the second position.
 15. The surgicalaccess apparatus according to claim 14, further including a controlmember disposed in mechanical cooperation with the tip and extendingalong at least a portion of the obturator sleeve, the control memberbeing actuable to move the tip between the first position and the secondposition.
 16. The surgical access apparatus according to claim 15,wherein the control member is actuable to move the tip distally relativeto the obturator sleeve.
 17. The surgical access apparatus according toclaim 15, further including a handle disposed in mechanical cooperationwith the control member, wherein rotation of the handle about a handleaxis actuates the control member and moves the tip between the firstposition and the second position.
 18. The surgical access apparatusaccording to claim 17, wherein the gear is disposed between the handleand the control member.
 19. The surgical access apparatus according toclaim 14, wherein the gear is a bevel gear.
 20. The surgical accessapparatus according to claim 14, further including a notch disposed onone of the obturator sleeve or the tip, and a key disposed on the otherof the obturator sleeve or the tip, the notch and the key cooperate toselectively prevent the tip from rotating about the axis of rotationrelative to the obturator sleeve.